Healthcare Provider Details

I. General information

NPI: 1538220249
Provider Name (Legal Business Name): SHARON L DOW DDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 07/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 HARLEY ST
JONESVILLE MI
49250
US

IV. Provider business mailing address

PO BOX 65 211 HARLEY ST
JONESVILLE MI
49250
US

V. Phone/Fax

Practice location:
  • Phone: 517-849-9195
  • Fax: 517-849-9611
Mailing address:
  • Phone: 517-849-9195
  • Fax: 517-849-9611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number7406
License Number StateMI

VIII. Authorized Official

Name: MRS. SHARON L DOW
Title or Position: OWNER
Credential: DDS
Phone: 517-849-9195